A method of identifying a patient who is non-compliant with prescribed diet and/or phosphate binder regimen calculates a phosphorus-protein ratio (PPR) by calculating the patient's protein intake, measuring the patient's serum phosphorus concentration, and estimating the amount of phosphorus removed by the patient's kidneys from measured residual urea clearance. The PPR is the ratio between the total amount of phosphorus removed from the patient and the patient's protein intake. The method enables identifying a patient that is non-compliant with prescribed diet and/or phosphate binder regimen if the PPR is outside of an acceptable range.
Legal claims defining the scope of protection, as filed with the USPTO.
1. A method of identifying a patient who is non-compliant with a prescribed diet and/or a phosphate binder regimen over a defined time interval prior to a medical treatment in which phosphorus is removed from the patient, comprising: a) determining the patient's protein intake over said defined time interval; b) determining the amount of phosphorus removed from the patient during said defined time interval and removed by said medical treatment; c) calculating a ratio between the amount of phosphorus removed from the patient and the patient's protein intake over said defined time interval; and d) identifying a patient that is non-compliant with a prescribed diet and/or a phosphate binder regimen if the ratio is outside of an acceptable range.
2. The method of claim 1 , in which determining the amount of phosphorus removed from the patient during said defined time interval and removed by said medical treatment includes: a) measuring the patient's serum phosphorus concentration before and after said medical treatment to determine the amount of phosphorus removed from the patient by said medical treatment; b) estimating the amount of phosphorus removed by the patient's kidneys during said defined time interval; c) determining the amount of phosphorus that would be removed from the patient by the prescribed phosphate binder regimen; and d) adding the amounts determined and estimated in steps a), b), and c).
3. The method of claim 1 , wherein the medical treatment comprises dialysis treatment.
4. The method of claim 3 , wherein estimating the amount of phosphorus removed by the patient's kidneys is based upon the patient's measured residual urea clearance.
5. The method of claim 1 , wherein said phosphate binder regimen comprises ingestion of phosphate binder tablets.
6. The method of claim 3 , wherein the defined time interval is the time interval between the end of one dialysis treatment and the beginning of the next subsequent dialysis treatment.
7. The method of claim 1 , wherein determining the patient's protein intake includes an in vitro measurement of blood urea nitrogen concentration using an automated clinical chemistry analyzer.
8. The method of claim 2 , wherein measuring the patient's serum phosphorus concentration includes an in vitro measurement using an automated clinical chemistry analyzer.
9. The method of claim 1 , wherein the acceptable range is between about 8 and about 14.
10. A method of identifying a patient who is non-compliant with a prescribed diet and/or a phosphate binder regimen over a defined time interval comprising: a) determining the patient's protein intake; b) estimating the amount of phosphorus removed by the patient's kidneys from measured residual urea clearance; c) determining the amount of phosphorus that would be removed from the patient by the prescribed phosphate binder regimen; d) determining a total amount of phosphorus removed from the patient; e) calculating a ratio between the total amount of phosphorus removed from the patient and the patient's protein intake; and f) identifying a patient that is non-compliant with prescribed diet and/or phosphate binder regimen if the ratio is outside of an acceptable range.
11. The method of claim 10 , wherein the defined time interval is the time interval between the end of one dialysis treatment and the beginning of the next subsequent dialysis treatment.
12. The method of claim 10 , wherein the acceptable range is between about 8 and about 14.
13. A computer system for identifying a patient who is non-compliant with a prescribed diet and/or a phosphate binder regimen over a defined time interval prior to a medical treatment in which phosphorus is removed from the patient, the computer system comprising: a) a user input means for determining patient data from a user; b) a digital processor coupled to receive determined patient data from the input means, wherein the digital processor executes a modeling system in working memory, wherein the modeling system: i) determines the patient's protein intake over said defined time interval; ii) determines the amount of phosphorus removed from the patient during said defined time interval and removed by said medical treatment; iii) calculates a ratio between the amount of phosphorus removed from the patient and the patient's protein intake over said defined time interval; and iv) identifies a patient that is non-compliant with a prescribed diet and/or a phosphate binder regimen if the ratio is outside of an acceptable range; and c) an output means coupled to the digital processor, the output means provides to the user the ratio between the phosphorus removed from the patient and the patient's protein intake.
14. The computer system of claim 13 , wherein the patient data includes blood urea nitrogen concentration and serum phosphorus concentration.
15. The computer system of claim 14 , wherein the blood urea nitrogen concentration is measured in vitro using an automated clinical chemistry analyzer.
16. The computer system of claim 14 , wherein the serum phosphorus concentration is measured in vitro using an automated clinical chemistry analyzer.
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October 1, 2010
September 2, 2014
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